Dr. Dirk Lazarus

Plastic, Reconstructive & Cosmetic Surgeon

MBChB (UCT), FCS (SA) Plast & Recon Surg

Nipple Areolar Issues

If you are uncertain as to which breast procedure(s) might be right for you then have a look at my page on breasts.

Inverted nipples may always be permanently inverted or occasionally so. For those that are only sometimes inverted, breast feeding, some forms of nipple piercing which keep the nipple out or a device called the niplette (made by Avent) may help. Nipples which are always inverted or those which do not respond to treatment with the niplette require surgery to correct.

Surgery is relatively minor. It is performed as day case surgery and can be done simply under local anaesthesia. Once anaesthetised, the nipple is incised and the fibrous bands causing the inversion are divided. To maintain the everted position, internal dissolving sutures are placed. Recovery is quick and you can resume normal activities shortly after surgery. Recurrence (return to an inverted nipple), can sometime occur.

Long/big nipples
Long or big nipples can be surgically reduced. Surgery is performed similarly to inverted nipple surgery except that excess nipple tissue is removed.

Before and after nipple reduction in a male

Before and after nipple reduction in a male

Areolar reduction
Large areolas may occur with large breasts in which case an areolar reduction will be done at the time of and as part of breast reduction. Similarly with other breast surgery, areolar reduction can be combined with the more major procedure.

Areolar reduction can also be done on as an isolated procedure. A donut of tissue can be excised to reduce areolar size. Bringing the larger outer circle to the smaller circle around the newly reduced areola can cause some puckering (a purse string effect), but this usually resolves after a few months. To prevent the areolas from widening out again in time, a permanent suture is left in around the areola. This permanent suture can sometimes be palpable (you can feel it) and if the suture ruptures the areola can stretch again. A peri-areola scar is the result of this procedure. Nevertheless areolar reduction, which is a relatively small procedure which can be done under local anaesthesia, is usually satisfying to the patient.



I’m a 30 year old flight attendant with previously AA cup size, I’ve always wanted Brest augmentation since the age of 19 when i knew my breast weren’t gonna grow any further. Anyway I’m based in the Middle East and initially wanted to do my surgery in Thailand but change my mind last minute and started researching plastic surgeons in Cape town, where I’m from. I thought it’s much better if im home with family and surrounded my people that can help me in my initial recovery period, Dr Dirks page popped up and I immediately emailed him, he replied almost instantly and I was very impressed. I then delt with Anneli the secretary over the last few months before my face to face consultation with Dr Dirk and she answered all my nervous questions via email, everyone was so professional and really helpful. Got my three weeks vacation holiday and did my surgery about two weeks ago and never looked back. Dr Dirk and his team are absolutely fantastic!!!! I couldn’t be more happy with my 300cc choice and dont regret a single moment, this is the best gift I’ve bought myself! I can’t wait for the final result and show off my new boobies … Thank you Dr Dirk, Anelli, Danni and Elmari for such fabulous service and for taking such good care of me. Will definitely be recommending this surgery to all my flight attendant friends back in the Middle East !!!!

Breast Augmentation